Orthopedic Coding Alert

Medicare Final Rule:
MPFS Conversion Factor a Tough Pill for 2023
Unless Congress acts, CF will be significantly cut. The Centers for Medicare & Medica... Read more
E/M 2023:
Extend Prolonged Service Smarts With New Codes
CMS and CPT® still at odds over when to add extra time. The Centers for Medicare & M... Read more
Clip & Save:
Consult This Chart to Select Codes
To avoid confusion over code choice for your Medicare and private payer patients, and to c... Read more
Injections:
Count This Instead of Shots for Accurate TPI Tally
Here's why the number of overall shots is irrelevant to your code choice. When a patient ... Read more
Reader Questions:
Know Purpose of Shoulder Arthroscopy Before Coding
Question: Encounter notes indicate that the provider performed a level-four office e... Read more
Reader Questions:
Get Off on Right Foot With F/T Modifier Coding
Question: I'm relatively new to orthopedic coding, so a couple of the modifiers I'm f... Read more
You Be the Coder:
Allergic Arthritis Dx Nothing to Sneeze At
Question: Encounter notes indicate that a patient suffered from “allergic arthritis... Read more
From Diagnosis to Surgery:
Follow These Rules When Coding Total Knee Replacements
Do you know the condition that will lead to most TKRs? Patients who require total knee re... Read more
Surgery:
Wrist/Forearm Repair Comes With Several Coding Options
Also, there are imaging services that could come before the surgery. When a patient ruptu... Read more
Diagnosis Deep Dive:
Get the Lowdown on New Low Back Pain Codes
Check in on coding this tricky condition. Coding low back pain can be a challenge because... Read more
Reader Question:
Remember Combo Code on Tibia/Fibula Fix
Question: Encounter notes indicate that the surgeon performed osteotomy of a patient'... Read more
Reader Question:
Don’t Worry, Stress Views Are Codeable
Question: Encounter notes indicate that the orthopedist performed a level-three evalu... Read more
Reader Question:
7th Characters Go Deep for Some Conditions
Question: A patient had an unspecified displaced fracture of the first cervical verte... Read more
Reader Question:
Look to T Codes for These Arthroplasties
Question: Encounter notes indicate that the orthopedist removed two total disc arthro... Read more
Reader Question:
Have You Heard? PHE Renewed Again
Question: What is the current status of the PHE for COVID-19, and when can we expect it to... Read more
You Be the Coder:
Look to Specific Dx for Felty’s Syndrome
Question: Encounter notes indicate that after a level-four evaluation and management (E/M)... Read more
Condition Spotlight:
Use This Guide to Diagnosing Stenosis
Symptoms typically include pain in spine, extremities. Patients who need treatment for sp... Read more
Condition Spotlight:
Conservative Tx Should Precede any Surgery for Spinal Stenosis
Providers rely on injections, rehab, PT before surgery. Once your provider confirms a cas... Read more
Compliance:
Code Correctly for Time to Avoid E/M Audits
Look for expert advice to take back to your practice. Using total time rather than counse... Read more
Reader Questions:
Get on Right Plane for Fixation Coding
Question: What is the difference between a uniplane external fixation system and mult... Read more
Reader Questions:
Answer Manipulation Question Before Coding This Dislocation Tx
Question: Encounter notes indicate that the provider performed treatment of a sterno... Read more
Reader Questions:
Use Px Status to Decide Code on E/M-Myelography Claim
Question: Encounter notes indicate that after an office evaluation and management (E/... Read more
You Be the Coder:
Coding CTs for Shoulder Cysts
Question: A new patient reports to the orthopedist complaining of left shoulder pain.... Read more
CPT® 2023:
Arthroplasty, US Highlight Coding Changes
Here's what you'll report instead of +0163T in 2023. The AMA has finalized its list of CP... Read more
Surgical Coding:
Divide and Conquer These 3 Vertebral Surgeries
Differentiate among excision/corpectomy/osteotomy, then choose a code. Orthopedic coders ... Read more
News You Can Use:
Telehealth Legislation Looks to Extend Benefit Beyond PHE
Expect more changes in the coming months, too. If your organization has relied heavily on... Read more
Reader Questions:
Congress Passes Bill to Protect Telehealth — for now
Question: Have there been any official, federal government-led moves to make any of t... Read more
Reader Questions:
Look for Combo Code for This Common 2-Condition Dx
Question: If a patient has lumbago and sciatica, should I report each condition separ... Read more
Reader Questions:
Get More Info Before Choosing Spina Bifida Dx
Question: Encounter notes indicate that the provider treated a patient suffering fro... Read more
Reader Questions:
Rein in Behavior That Could Compromise ePHI
Question: A provider in our practice informed us that they have been sending patient... Read more
You Be the Coder:
Follow the Clues to This Spinal Injury Dx
Question: Encounter notes indicate that the orthopedist performed a level-three evalu... Read more
E/M 2023:
Hospital Codes Getting Big Revisions
Here's the group of observation codes that CPT® is completely deleting. Here we go again... Read more
ICD-10 2023:
Check Out the Expansion of This Epiphysis Code Group
The M93.0- code set is about to get bigger. When ICD-10 2023 takes effect on Oct. 1, 2023... Read more
Modifier Madness, Pt. 2:
I.D. Separate E/M Before Coding With 25/57
Established patient + new problem? Don't assume billable E/M service. Get ready to round... Read more
Reader Questions:
Choose From These 3 Codes for Kaschin-Beck
Question: Encounter notes indicate that the provider performed an office evaluation a... Read more
Reader Questions:
Separate Synovectomy Types Before Coding
Question: Encounter notes indicate that after a level-three office evaluation and man... Read more
Reader Questions:
Recessions Are for Hamstrings As Well As Economies
Question: I overheard a colleague discussing a proximal hamstring recession. I assume... Read more
Reader Questions:
Ping This Code for PENG Blocks
Question: Do you know which CPT® code we should use for a PENG block? Ohio Subscrib... Read more
You Be the Coder:
2 Toe Fractures, Same Foot
Question: Encounter notes indicate that the provider performed closed treatment on a ... Read more
ICD-10 2023:
Muscular Dystrophy Codes Highlight New Additions
Intraoperative/postprocedural complications get new codes, too. The final list for ICD-10... Read more
Aspirations & Injections:
Keep Up With These Common Needle Procedures
Policy will drive whether to report dry needling. Patients that report to the orthopedist... Read more
Modifier Madness, Pt. 1:
I.D. E/M Before Coding With 25/57
Remember, global days dictate which modifier is correct. When it comes to modifiers 25 an... Read more
Reader Questions:
When a Diagnostic Procedure Turns Surgical, Coding Changes
Question: What is the difference between a diagnostic and a surgical elbow arthroscop... Read more
Reader Questions:
March Forward After Getting More Fracture Info
Question: Encounter notes indicate that the provider performed a level-three evaluati... Read more
Reader Questions:
Don’t Thumb Your Nose at This Specific Fracture Code
Question: What is a Bennett fracture, and how do I report CPT® and ICD-10 codes for ... Read more
Reader Questions:
No Horsing Around: This Condition Has a Specific Dx
Question: Notes indicate that the patient had “charley horse r calf.” Are there a... Read more
You Be the Coder:
Shoulder Injury Leading to Surgery
Question: An established patient reports to the orthopedist with a right shoulder injury. ... Read more
Surgical Coding:
Turn Rotator Cuff Fixes Into Coding Gold
Know how your provider might diagnose, treat these injuries. When your orthopedist treats... Read more
Injections:
Consider Guidance, Joint Size on These Injections
Coding varies depending on whether joint is small, intermediate, major. Coding for joint ... Read more
E/M Coding:
Roll With Incident-to Rules to Get Max E/M Payment
Here's why all incident-to services must have established care plan. If your orthopedic... Read more
Reader Questions:
Focus on This Congenital Syndrome
Question: What is os trigonum syndrome and which ICD-10-CM code should I report for t... Read more
Reader Questions:
Get Modifier Right on Surgery-E/M Combo Encounter
Question: Encounter notes indicate that the surgeon performed an office/ outpatient ... Read more
Reader Questions:
Get More Info, Land Most Accurate Codes for Neck Dx/Tx
Question: The provider treated a patient who came in complaining of neck pain that's ... Read more
Reader Questions:
Alternate Terms Bring This Disc Disorder Dx to Light
Question: Encounter notes indicate that the provider diagnosed C2-C3 disc disorder w... Read more
You Be the Coder:
Multiple Arthrodeses, 1 Session
Question: Encounter notes indicate that the provider performed two arthrodesis surgeries: ... Read more
Fracture Care 101:
Follow These Steps to Break Into Closed Tx Coding
Did you know traction can accompany closed fracture treatment? When your orthopedist perf... Read more
Surgery Coding:
I.D. Partial/Total Hip Replacements, Stride to Coding Success
Do you know the key terms that can lead you to the right replacement code? When your su... Read more
E/M Coding:
Max Out Claims by Knowing Non-Faceto- Face Time
Know how to capture work that occurs beyond the patient encounter. Every coder knows how ... Read more
Reader Questions:
Choose Osteotomy Combo Code in Some Scenarios
Question: Encounter notes indicate that the provider performed osteotomies on the dis... Read more
Reader Questions:
Scour Notes for Every Osteomyelitis Dx Detail
Question: During a level-three office evaluation and management (E/M) service for a n... Read more
Reader Questions:
Don’t Confuse Dupuytren Contracture With This Common Dx
Question: Encounter notes indicate that the patient suffered from Dupuytren contractu... Read more
You Be the Coder:
Needle Guidance for X-rays
Question: Encounter notes indicate that the provider performed a right wrist arthrography,... Read more
ICD-10 Coding:
Bone Up on Rules for Osteoarthritis Dx Coding
Hip/knee osteoarthritis most common for many ortho practices. Patients often report to th... Read more
Modifier Madness:
Keep 26, 54 Close for Partial Service Coding
Do you know when to use professional component modifier? There are times when your ortho... Read more
Case Study Corner:
Check Out These Limited/Complete Wrist Arthrodesis Claims
Master scenarios like these and arthrodesis coding will improve. In our last issue (Volum... Read more
You Be the Coder:
Getting a Spot-On Synovia Excision Code
Question: The orthopedist performed an office evaluation and management (E/M) service for ... Read more
Reader Questions:
Mine Alternate Terms on Muscular Dystrophy Dx
Question: What is the diagnosis code for a patient with muscular dystrophy? AAPC Forum Su... Read more
Reader Questions:
#Resequenced Is Always Trending in CPT® Manual
Question: I was coding for a patient who had a spinal puncture, and was perusing this sect... Read more
Reader Questions:
And/Or Can Make a Big Difference in Surgical Coding
Question: Encounter notes indicate that the surgeon performed repair of a nonunion in a pa... Read more
Reader Questions:
Mark Multiple-Region Myelographies With These Codes
Question: How do I report myelography? Texas Subscriber Answer: This will depend on how ... Read more
Reader Questions:
Don’t Throw in the Towel When Presented With Tough Discitis Dx
Question: Encounter notes indicate that the patient suffered from “discitis.” That's a... Read more
Surgery:
Learn Code Specifics, Lower Risk on Wrist Arthrodesis Claims
Here's the code to choose for complete arthrodesis with sliding graft. Patients who repor... Read more
Case Study Corner:
Check Out These Wrist Arthrodesis Scenarios
Do you know the difference between total and partial arthrodesis? When a patient presen... Read more
E/M Coding:
Use VANDALISM to Verify Hospital Care Specifics
Mnemonic device can help you ace hospital claims. Getting all the information just right ... Read more
Modifier Madness:
Keep Q6 in Mind for Locum Tenens/FTC Claims
Do you know the new Medicare term for locum tenens? When one of your physicians takes a ... Read more
Reader Questions:
Get Hip to Contracture ICD-10 Rules
Question: Encounter notes indicate that the provider performed an office evaluation a... Read more
Reader Questions:
Remember X Factor for These 7 Character Dx Codes
Question: Encounter notes indicate that a patient suffered from periprosthetic fractu... Read more
Reader Questions:
Follow These Steps to Correct Sternoclavicular Dislocation Code
Question: What is a sternoclavicular dislocation, and how do I report surgical repair... Read more
Reader Questions:
Use This Current Conditions Guidance for Tricky Dx
Question: When preparing a claim, should you enter the diagnosis code only for the co... Read more
Reader Questions:
Use This Advice for Previous Patient E/Ms
Question: If a patient sees one surgeon in our practice, then one year later sees a ... Read more
You Be the Coder:
Coding Multiple Rib Fractures
Question: Encounter notes indicate that the surgeon performed open treatment of multi... Read more
News You Can Use:
Late-Year Push Ups CF (Slightly) As Errata Straightens Spinal Issues
In a rare move, CMS increased the CF after the final rule this year. The new year has ar... Read more
Condition Spotlight:
Know Diagnostic, Surgical Codes for Achilles Claims Success
Do you know what a Thompson test is? Coders that have any concerns about their ability t... Read more
E/M Coding:
Get Back to the Basics on Hospital Coding
Inpatients staying more than 1 day have different codes. When your orthopedist performs ... Read more
Reader Questions:
CPT® Rolls Out New Telehealth Modifier
Question: I heard there was a new telehealth modifier that we're supposed to be using... Read more
Reader Questions:
Look to This Dx for Ligamentous Laxity
Question: Notes indicate the provider treated a patient with “ligamentous laxity, R... Read more
Reader Questions:
Check Out Category M72.- for Plantar Fasciitis
Question: The provider diagnosed the patient with plantar fasciitis. What is plantar ... Read more
You Be the Coder:
Can You Make All the Right Coding Moves on This Fx Encounter?
Question: Notes indicate that the surgeon performed an outpatient evaluation and manageme... Read more
CMS Final Rule:
Conversion Rate Dips for 2022
No increase in pay for providers this year. The final rule has finally been published, an... Read more
Imaging:
Get Specific When Choosing MRI Code
Anatomy only the beginning when looking for right MRI code. Patients that report to you... Read more
Case Study Corner:
Be Ready When Knee Arthroscopy Turns Surgical
Do you know if you can code for a Dx and surgical arthroscopy on same injury? Patients ... Read more
Reader Questions:
Get Specific Details on Prosthetic Shoulder Removal
Question: If we remove a prosthetic shoulder implant, how can we code for it? Also, are th... Read more
Reader Questions:
Use T Codes for Additional Interspace Removals
Question: Encounter notes indicate that the surgeon removed a total disc arthroplasty (art... Read more
Reader Questions:
Remember 7th Character on Fracture
Question: Notes indicate the provider performed a level-four office evaluation and managem... Read more
Reader Questions:
Keep Up With Modifier 25 Rules
Question: Have the modifier 25 rules changed now that the E/M guidelines are different? My... Read more
You Be the Coder:
Get Specifics of Anatomy Right on PET Scan
Question: Notes indicate our provider performed ‘PET scan, whole body.' I reported 78811... Read more
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